COVID-19 vaccines and pregnancy explained: What it means for expectant and new mums

Australian health officials say there is “insufficient evidence” to determine if the COVID-19 vaccine is safe for pregnant women.

Tens of thousands of Australian women are still in the dark about how safe the COVID-19 vaccine will be after the Royal Australian and New Zealand College of Obstetricians and Gynaecologists said there was “insufficient evidence” to determine its safety for at risk groups.

Chief among these groups are people who are pregnant, breastfeeding, or planning to fall pregnant in the near future.

Here’s everything we know so far about the COVID-19 vaccine for pregnant and breastfeeding women, and those planning to fall pregnant in the near future.

Data collected from similar vaccines suggest there is no risk, but pregnant and breastfeeding women have not yet been included in COVID-19 vaccine clinical trials. Picture: iStock

Is it safe for pregnant women and new mothers to receive a COVID-19 vaccine?

Due to the newness of the vaccine, it is still too early to definitively know one way or the other.

Data collected from studies of similar vaccines suggest the vaccine is safe, however no pregnant or breastfeeding women have been included in COVID-19 vaccine clinical trials, meaning risk cannot be ruled out entirely.

On Tuesday, RANZCOG advised, “Although the available data do not indicate any safety concern or harm to pregnancy, there is insufficient evidence to recommend routine use of COVID-19 vaccines during pregnancy.”

However RANZCOG President Dr Vijay Roach says women with pre-existing medical conditions that could be worsened by contracting COVID-19 should strongly consider having the vaccine before falling pregnant or during pregnancy, and recommends talking to your obstetrician, GP or midwife about your options.

Will contracting COVID affect my pregnancy?

It might. Data has shown that the vast majority of women who contracted COVID-19 while pregnant experienced mild flu-like symptoms. However, RANZCOG notes that “pregnant women are potentially at increased risk of complications from any respiratory disease due to the physiological changes that occur in pregnancy.”

There are only a handful of cases in which newborns have contracted COVID-19, and there is not yet enough information available to know if the virus was contracted after birth or in utero.

COVID cannot be transmitted through the vaccine. Picture: iStock

Is one vaccine safer than others for pregnant or breastfeeding women than others?

It is still too early to know definitively, but an obstetrician, GP or midwife can discuss the options with you in further detail.

Can pregnant women contract COVID-19 from a vaccine?

No. None of the approved vaccines contain live virus, meaning it cannot be transmitted through vaccination.

Can a COVID-19 vaccine cause miscarriage?

No. There is no evidence to suggest that the virus itself or any of the approved vaccines can cause miscarriage.

Is it safe for women planning to get pregnant in the near future to receive vaccination?

Yes. There is no evidence to suggest women who fall pregnant after receiving a COVID-19 vaccine will face increased risks of maternal illness, birth defects, or miscarriage.

When will we know if the vaccine is unequivocally safe for pregnant and breastfeeding women?

Stage 3 of a clinical trial can take anywhere from four months to four years to complete. Last year, Dr Anthony Fauci, the US’s top infectious disease expert, said studies including pregnant and breastfeeding women “will probably start in mid to late January.” Based on that date, it we will likely not have a concrete answer until 2022 at the very earliest.

Dr Roach says that realistically, that kind of data can take “years and years” to amass.

“It’s going to take large numbers and at least the length of a pregnancy to determine if there is any emerging evidence of harm. But based on what we know about vaccines in general, of the development of these vaccines and their relationship with the influenza vaccine … we don’t really have a reason to suspect there will be adverse outcomes,” Dr Roach says.

There’s a lot women can do to keep safe during the pandemic. Picture: iStock

Other countries are providing different advice on this issue. Why is that?

“It’s not different advice so much as different community circumstances,” Dr Roach says.

COVID-19 rates vary dramatically across the world. The United States, for example, currently has a total infection rate is over 25 million and a death toll of over 420,000. By contrast, during the same period of time, Australia has recorded a total of just under 29,000 cases and 909 deaths.

Based on these dramatically different figures, a pregnant woman living in the United States is currently far more likely to come into contact with the virus than a pregnant woman in living in Australia, and this is why advice for pregnant and breastfeeding women may be varying between national governments and independent peak bodies.

“In a setting of low community transmission we have the luxury of saying, ‘let’s just hang on a tick,’” Dr Roach says. “Given we’re so lucky to be in the situation we’re in, why don’t we just observe what happens in the United States and the UK and get a bit more data. And it may well be that within three or six months that we’re sufficiently reassured that pregnant women are safe to be vaccinated.”

What should I do to stay safe if I am pregnant or breastfeeding?

The good news is that there is a lot you can do to keep safe. In addition to maintaining a social distance of 1.5 metres from others, wearing a mask and regularly washing your hands also helps hugely in stopping the spread of COVID-19.

If you work in a setting of high risk, RANZCOG recommends ensuring PPE equipment guidelines are followed, and working from home or transferring to a low-risk area where possible.

Originally published as COVID-19 vaccines and pregnancy explained: What it means for expectant and new mums